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Mammography: a very brief history

Breast cancer is not new, but the means we use to detect and study it are. Mammography, the science used to examine the breast, only began to develop its roots in the last century. Since then, the means and methods to detect cancerous tumors have only changed.

It wasn’t until 1895 that X-rays were developed. In 1913, a German surgeon named Alfred Salomon became the first person to attempt to visualize breast cancer using radiology. Salomon used what was the conventional X-ray machine of the day to examine samples from over 3,000 mastectomies he had performed. From this, he was able to gain a better understanding of what was or was not normal in breast tissue, thus establishing himself as the father of modern mammography. Salomon’s research, however, was only the beginning of the development of the field.

In 1930, Dr. Stafford L. Warren provided a breakthrough in the field. Stafford’s research supported the effectiveness of mammography as a diagnostic tool for breast cancer, and he further developed a stereoscopic technique for the field. Warren’s research further found that a side-by-side comparison of the left and right breasts could do even more to detect abnormalities, further simplifying diagnosis of the disease. In 1949, the Uruguayan doctor Raúl Leborgne developed the compression method. A radiologist by profession, Leborgne invented a device that held the breast flat between a cone and a pad while an X-ray was taken. This method allowed the radiograph to produce a better quality image overall, making the diagnostic process simpler and more accurate. Additionally, Leborgne was the first to suggest looking for microcalcification in the breast, which refers to the appearance of tiny white dots that can be an early indicator of developing cancer.

The next big advance in mammography came in the late 1950s, when Houston radiologist Robert Egan introduced the use of a fine-grain screen and industrial film to produce clearer images. With his team at MD Anderson Cancer Center in Houston, Egan examined images of the breasts of 1,000 women who showed no obvious signs of cancer. Upon closer examination, Egan and the other researchers found 238 cancerous masses among the results.

Mammograms became commonly accepted as a means of screening for breast cancer in the 1960s, and a study conducted between 1963 and 1966 found that they could reduce breast cancer deaths by a third. A high-definition display developed in 1972 gave X-ray technicians much sharper images. Twenty years later, Congress enacted the Mammography Quality Standards Act, ensuring that all women can access appropriate breast cancer care when needed.

The field has continued to grow. As recently as last year, the Journal of the American Medical Association published a study that found 3D technology excelled at detecting cancer compared to traditional mammography. It’s hard to say what the next few years will bring, but there will almost certainly be more to come.

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